Ask the Expert: When to Consider Surgery for Hip Pain

Dr. Peter Hanson

The hip joint, which is the body’s largest ball-and-socket joint, is designed to withstand repetitive motions and a normal amount of wear and tear. However, with age and use, the joint may experience a number of conditions that can lead to hip pain, including damage or wear of the cartilage, overuse of muscles and tendons in the hip or a fall or other injury that can lead to a hip fracture.

Dr. Peter Hanson, a Sharp Grossmont-affiliated orthopedic surgeon, answers a few questions about hip pain, methods used to manage or treat pain and how to decide if surgery is the right treatment option for you.

How severe can hip pain become?
When hip pain occurs because of an injury, certainly a patient can judge whether they need to see a physician based upon the intensity of the pain or the disability that’s there. If they have some minor pain that they think they can treat at home, things like ice and anti-inflammatories can be very helpful. If that pain continues, they really should seek the evaluation of a health care practitioner for that because bad things can happen with hip pain.

How is hip pain caused?
One cause of hip pain is hip arthritis. It’s fairly common, especially as our population ages, and with our active population it can start out as an ache or it can start out as a very acute type of pain even though they may have arthritis for a long time and didn’t realize it. If that type of pain occurs, most people will try some home remedies like ice and anti-inflammatories, and if the pain or disability is severe enough, they really should seek the advice of a physician. A very simple and physical exam and X-ray can tell us if you have that kind of a problem.

When should I consider surgery to treat my hip pain?
Hip surgery should be considered only after all conservative, nonoperative attempts have been made to control your pain. Deciding to have hip surgery is typically left as a last resort, when the pain is bad enough or chronic enough to limit your ability to live your life in relative comfort.

How has hip surgery advanced in recent years?
There have been several advances in hip replacements in the last few years. Unfortunately, not all of them have been good. Alternative bearing surfaces, such as metal-on-metal or ceramic-on-ceramic, were pushed extensively in the joint industry, but problems have arisen that were unanticipated and sometimes disastrous. Not all patients with alternative bearing surfaces experienced problems after their surgery, but those who had issues experienced them in a major way.

What about the latest, minimally invasive hip replacement surgeries you perform involving the anterior approach?
Learning to do anterior hip replacements, in which the hip joint is accessed from the front (anterior) versus the back (posterior), has made a very big difference in my practice and the results I am able to provide my patients. A hip replacement is a big operation fraught with potential risks, but some of these risks, such as dislocations and leg-length discrepancies, have been decreased in my hands with this approach.

For the last six years, the anterior approach has been my exclusive method of replacing hips, and I have performed several hundred procedures. It is the most important change I made in my orthopedic practice and I’m happy to have made the choice to change when I did.

Find a San Diego Orthopedic Surgeon
To learn more about orthopedics at Sharp or to find a Sharp-affiliated doctor, search for San Diego orthopedic surgeons or call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, from 8 am to 6 pm.

For More Orthopedics Information
To find general information about orthopedics, visit Orthopedic Surgery in Adult Health or read the Orthopedics News archive.